Descriptive Epidemiology and Burden of Colorectal Cancer CRC

Descriptive Epidemiology and Burden of Colorectal Cancer (CRC) United States, 1998 -2001 J *Missouri * Jackson-Thompson , RR † German , F † Ahmed , SM ± Lai , C †† Friedman Cancer Registry/University of Missouri; †Centers for Disease Control and Prevention (CDC) National Program of Cancer Registries; ±Kansas Cancer Registry/University of Kansas; TABLE 1: Incidence Counts of Invasive Colorectal Cancer by Registry, United States, 1998 -2001, a • Colorectal cancer (CRC) is one of the most common cancers and biggest killers worldwide. 8, 986 Missouri 13, 775 Alaska 858 Montana 2, 033 Arizona 9, 355 Nebraska 4, 280 California 57, 402 New Jersey 22, 205 Colorado 6, 751 New Mexico 2, 834 Connecticut 8, 896 New York 47, 799 District of Columbia 1, 375 North Carolina 15, 484 Florida 45, 942 Ohio 27, 144 Metro Atlanta (Georgia) 3, 912 Oklahoma 7, 648 Methods: Hawaii 2, 682 Oregon 7, 127 Idaho 2, 181 Pennsylvania 36, 399 • We used SEER*Stat to analyze CRC data (n=542, 149) from 39 states, D. C. and metro Atlanta, representing 88% of U. S. population, that met high-quality data criteria for 1998 -2001. Illinois 28, 660 Rhode Island 2, 957 Indiana 13, 783 South Carolina 8, 407 Iowa 8, 568 Texas 33, 128 Kansas 6, 215 Utah 2, 645 Kentucky 10, 050 Vermont 1, 395 Louisiana 9, 803 Washington 11, 290 Maine 3, 422 West Virginia 5, 133 Massachusetts 16, 091 Wisconsin 13, 120 Michigan 21, 380 Wyoming 970 Minnesota 10, 064 TOTAL 542, 149 • The vast majority of CRC cases and deaths can be prevented by applying existing knowledge about cancer prevention and by using recommended screening tests. Purpose: • To describe the burden of CRC in the United States (U. S. ). a, b, c United States, 1998 -2001, ________________________________________ Registry Number ________________________________________ Alabama Comprehensive Cancer Control Branch Invasive Colorectal Cancer for Females by SEER Summary Stage and Race/Ethnicity 45% 40% 35% Percentage of Cases Background: ††CDC 30% 25% 20% 15% 10% 5% 0% Localized Regional Distant Unstaged Summary Stage White Black API Hispanic Invasive Colorectal Cancer for Males by SEER Summary Stage and Race/Ethnicity United States, 1998 -2001, a, b, c 45% Results: 40% • Females are 87% white, 9. 5% black and 2% Asian/Pacific Islander API). Males are 88% white, 8% black, and 2% API. 35% • For males, median age at diagnosis ranges from 66 (black) to 71 (white); for females, range is 68 (API and Hispanic) to 75 (white). • Most invasive CRC cases are staged; unstaged cases range from 6. 7% for API males to 11. 6% for black females. • Diagnosis at localized stage is most likely for white and API males (36%) and females (34%) and least likely for blacks (30% for each gender). 30% Percentage of Cases • Race and ethnicity are known for >99% of cases, subsite for 94% of cases. 25% 20% 15% 10% 5% 0% Localized Regional Distant Unstaged Summary Stage Table 2: Invasive Colorectal Cancer by Selected Features United States, 1998– 2001, a, b __________________________________________________ Feature Male Female Total (n = 273, 195) ( n = 268, 954) (n = 542, 149) __________________________________________________ Overall 66. 1 (100) 47. 8 (100) 55. 6 (100) White 65. 7 (88. 1) 47. 0 (87. 1) 55. 1 (87. 6) Black 70. 1 (8. 3) 53. 7 (9. 5) 60. 2 (8. 9) Asian/Pacific Islander 48. 1 (2. 2) 35. 3 (2. 1) 40. 9 (2. 2) Other - (0. 6) - (0. 5) Unknown - (0. 8) Race Non-Hispanic 66. 9 (94. 8) 48. 5 (95. 3) 56. 4 (95. 0) Hispanic 53. 9 (5. 2) 36. 5 (4. 7) 43. 8 (4. 9) - (0. 0) Proximal colon 25. 4 (37. 5) 21. 7 (46. 0) 23. 2 (41. 8) Distal colon 17. 3 (26. 5) 11. 5 (23. 7) 14. 0 (25. 1) Colon, NOS 4. 0 (5. 8) 3. 0 (6. 4) 3. 4 (6. 1) 19. 5 (30. 2) 11. 6 (23. 9) 15. 1 (27. 1) Subsited NOTE: This project was supported in part by a cooperative agreement between the Centers for Disease Control and Prevention (CDC) and the Missouri Department of Health and Senior Services (DHSS) (#U 55/CCU 721904 -05) and a Surveillance Contract between DHSS and the University of Missouri. Rectum Black API Hispanic Conclusion: These findings provide valuable information for guiding cancer control and prevention efforts related to reducing the burden of CRC (http: //www. cdc. gov/cancer/index. htm). Despite the size of the 1998 -2001 dataset, the largest CRC dataset analyzed to date, incidence rates could not be presented for AI/ANs. Rates for populations other than white and black may be affected by problems in ascertaining race/ethnicity from basic records (e. g. , medical records, death certificates, etc). Footnotes: Ethnicity Unknown White a Data are from population-based cancer registries that participate in the National Program of Cancer Registries (NPCR) and/or the Surveillance, Epidemiology, and End Results (SEER) Program and meet high quality data criteria (see Table 1 for list of registries). These registries cover approximately 88% of the U. S. population. b The data represent incidence rates (% distribution of cases) unless otherwise specified. Rates are per 100, 000 persons and are age-adjusted to the 2000 U. S. standard population. Hispanic origin is not mutually exclusive from race categories (white, black, Asian/Pacific Islander). Rates could not be calculated for persons of other or unknown race/ethnicity. c SEER Summary Stage (based on 257, 519 male and 254, 335 female cases; excludes data for California outside of Los Angeles, San Francisco-Oakland, and San Jose-Monterey). d Proximal colon: cecum to splenic flexure (C 18. 0 -C 18. 5); Distal colon: descending and sigmoid colon (C 18. 6 -C 18. 7); Colon, NOS (C 18. 8 -C 18. 9; C 26. 0); Rectum (C 19. 9; C 20. 9). International Classification of Diseases for Oncology, 3 rd Edition site codes. (Histology codes 9590 -9989 excluded. )